Provider Demographics
NPI:1689645863
Name:RUBIO-YATES, SONIA L (OT)
Entity Type:Individual
Prefix:PROF
First Name:SONIA
Middle Name:L
Last Name:RUBIO-YATES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13285 LAKESIDE TER
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33330-2666
Mailing Address - Country:US
Mailing Address - Phone:954-454-3445
Mailing Address - Fax:954-454-0029
Practice Address - Street 1:5651 DAVIE RD.
Practice Address - Street 2:STE B
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4729
Practice Address - Country:US
Practice Address - Phone:954-454-3445
Practice Address - Fax:954-454-0029
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT3138225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ5183OtherBLUE CROSS BLUE SHIELD
FLZ5183ZMedicare PIN